Brain Imaging Aids in Diagnosing Dementia

The use of advancedd technology to detect and diagnose brain abnormalities has advanced significantly over the past decade. A new review finds a particular method of positron emission tomography (PET) can safely and accurately detect dementia and Alzheimer’s disease.

PET technology is an advanced radiological method that provides functional images of biological processes. In the analysis, researchers discovered a molecular imaging technique that combines PET with an injected biomarker called 18F-FDG helps to pinpoint key areas of metabolic decline in the brain indicating dementia.

Researchers believe use of PET will provide clinicians with physiological evidence of neurodegenerative disease. This knowledge will expedite and improve the accuracy of physician diagnosis.

“The new data support the role of 18F-FDG PET as an effective addition to other diagnostic methods used to assess patients with symptoms of dementia,” said Nicolaas Bohnen, M.D., Ph.D., lead author of the study.

“The review also identified new literature showing the benefit of this imaging technique for not only helping to diagnose dementia but also for improving physician confidence when diagnosing a patient with dementia. This process can be difficult for physicians, especially when evaluating younger patients or those who have subtle signs of disease.”

Dementia is a challenging diagnosis because it is not a specific illness but a pattern of symptoms characterized by a loss of cognitive ability. Cognitive decline may be caused by injury or progressive disease affecting areas of the brain that control attention, memory, language and mobility.

Alzheimer’s is most commonly associated with progressive memory impairment, although dementia with Lewy bodies can be associated with symptoms of Parkinson’s and prominent hallucinations. Another disorder, called frontotemporal dementia, is found in patients showing uncharacteristic personality changes and difficulties in relating and communicating.

Researchers believe expanded use of FDG-PET will help physicians diagnose dementia and help differentiate between disorders.

Already, the diagnosis of dementia includes a criteriion that physicians use evidence from molecular imaging studies.

“For the first time, imaging biomarkers of Alzheimer’s disease are included in the newly revised clinical diagnostic criteria for the disease,” said Bohnen.

“This is a major shift in disease definition, as previously an Alzheimer’s diagnosis was based mainly on a process of evaluating patients to exclude possible trauma, hemorrhage, tumor or metabolic disorder. Now it is becoming a process of inclusion based on biomarker evidence from molecular imaging.”

“The earlier we make a diagnosis, the more we can alleviate uncertainty and suffering for patients and their families.”

The biomarker 18F-FDG is among a variety of imaging agents being investigated for its efficacy in Alzheimer’s imaging.

As treatments for dementia become available for clinical use, PET will no doubt play an important role in not only the diagnosis of these diseases, but also the assessment and monitoring of future therapies.

According to the World Health Organization, an estimated 18 million people worldwide are currently living with Alzheimer’s disease. That number is projected to almost double by 2025.

The research is found in the current issue of The Journal of Nuclear Medicine.

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About Rick Nauert PhD

Dr. Rick Nauert has over 25 years experience in clinical, administrative and academic healthcare. He is currently an associate professor for Rocky Mountain University of Health Professionals doctoral program in health promotion and wellness. Dr. Nauert began his career as a clinical physical therapist and served as a regional manager for a publicly traded multidisciplinary rehabilitation agency for 12 years. He has masters degrees in health-fitness management and healthcare administration and a doctoral degree from The University of Texas at Austin focused on health care informatics, health administration, health education and health policy. His research efforts included the area of telehealth with a specialty in disease management.